Cabozantinib May Improve Survival in mCRPC Patient Subgroup
COMET-1 and COMET-2 previously showed no overall survival benefit with cabozantinib.
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Cabozantinib may benefit post-docetaxel patients with metastatic castration-resistant prostate cancer (mCRPC) in groups controlled for prognostic risk factors, according to research presented at the 2018 Genitourinary Cancers Symposium in San Francisco, California.1
COMET-1 and COMET-2 (ClinicalTrials.gov Identifiers: NCT01605227 and NCT01522443, respectively), 2 phase 3 trials in which cabozantinib was compared with prednisone and prednisone plus mitoxantrone in post-docetaxel patients with mCRPC, showed no overall survival (OS) benefit with cabozantinib. For this study, researchers “conducted a retrospective analysis of a combined dataset of these trials in an attempt to identify a benefit in subsets of patients based on prognostic risk factors.”
Data from 1028 patients from COMET-1 and 119 patients from COMET-2 were included. The authors identified the following prognostic risk factors: age, albumin levels, lactate dehydrogenase levels, bone scan lesion area, site of metastases, pain, docetaxel-free interval, ECOG performance status, and hemoglobin, alkaline phosphatase, and prostate-specific antigen (PSA) levels.
Cabozantinib did not improve survival for patients with any particular prognostic risk factor. Yet after adjusting for multiple factors, a hazard ratio for OS of 0.77 was observed in favor of cabozantinib (P = .003).
The authors concluded that “no differential effect of cabozantinib on survival was observed for any prognostic risk factor. A modest treatment effect of cabozantinib on OS was observed after controlling for multiple potential prognostic factors.”
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- Pond GR, Sonpavde G, Fizazi K, et al. Cabozantinib for metastatic castration-resistant prostate cancer (mCRPC) following docetaxel: combined analysis of two phase III trials. Oral presentation at: 2018 Genitourinary Cancers Symposium; February 8-10, 2018; San Francisco, CA.